Search results for: surgical approach

Authors: Joanna Drzeżdżon

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Polyvinyl alcohol and its derivatives such as 2-chloro-2-propen-1-ol have found application in many industries. They are mainly used for the production of adhesives, thickeners and stabilizers of emulsion paints, and surgical threads. Moreover, polyvinyl alcohol derivatives are indispensable reagents in the synthesis of hemiacetals. Polyolefins derived from polyvinyl alcohol are obtained by using catalysts belonging to complex compounds of transition metal ions. The aim of the studies is to the synthesis of a new complex, i.e. dipicolinate oxovanadium(IV) complex with 4,4’-dimethoxy-2,2’-bipyridyl, and to determine its catalytic activities. Moreover, the another aim of the studies was to set conditions for 2-chloro-2-propen-1-ol oligomerization. The catalytic system has been based on the dipicolinate complex of oxovanadium(IV) with 4,4’-dimethoxy-2,2’-bipyridyl and MMAO-12. The results of the studies showed that how a new oxovanadium(IV) complex compound effects on the 2-chloro-2-propen-1-ol oligomerization. Moreover, the results revealed that new catalytic material is a highly active catalyst for the investigated oligomerization.

Keywords: 2-chloro-2-propen-1-ol, oligomerization, dipicolinate, vanadium, methylaluminoxane

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Authors: Langhit Kurar, Loren Charles

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Introduction: In light of recent BOAST 12 (August 2016) published guidance on management of ankle fractures, the project aimed to highlight key discrepancies throughout the care trajectory from admission to point of discharge at a district general hospital. Wide breadth of data covering three key domains: accident and emergency, radiology, and orthopaedic surgery were subsequently stratified and recommendations on note documentation, and outpatient follow up were made. Methods: A retrospective twelve month audit was conducted reviewing results of ankle fracture management in 37 patients. Inclusion criterion involved all patients seen at Darent Valley Hospital (DVH) emergency department with radiographic evidence of an ankle fracture. Exclusion criterion involved all patients managed solely by nursing staff or having sustained purely ligamentous injury. Medical notes, including discharge summaries and the PACS online radiographic tool were used for data extraction. Results: Cross-examination of the A & E domain revealed limited awareness of the BOAST 12 recent publication including requirements to document skin integrity and neurovascular assessment. This had direct implications as this would have changed the surgical plan for acutely compromised patients. The majority of results obtained from the radiographic domain were satisfactory with appropriate X-rays taken in over 95% of cases. However, due to time pressures within A & E, patients were often left without a post manipulation XRAY in a backslab. Poorly reduced fractures were subsequently left for a long period resulting in swollen ankles and a time-dependent lag to surgical intervention. This had knocked on implications for prolonged inpatient stay resulting in hospital-acquired co-morbidity including pressure sores. Discussion: The audit has highlighted several areas of improvement throughout the disease trajectory from review in the emergency department to follow up as an outpatient. This has prompted the creation of an algorithm to ensure patients with significant fractures presenting to the emergency department are seen promptly and treatment expedited as per recent guidance. This includes timing for X-rays taken in A & E. Re-audit has shown significant improvement in both documentation at time of presentation and appropriate follow-up strategies. Within the orthopedic domain, we are in the process of creating an ankle fracture pathway to ensure imaging and weight bearing status are made clear to the consulting clinicians in an outpatient setting. Significance/Clinical Relevance: As a result of the ankle fracture algorithm we have adapted the BOAST 12 guidance to shape an intrinsic pathway to not only improve patient management within the emergency department but also create a standardised format for follow up.

Keywords: ankle, fracture, BOAST, radiology

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Authors: David Suson

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In today's work environment, it becomes harder and harder to attract top talent, motivate them to achieve your goals, create a collaborative work environment and then retain them. It is especially challenging when you have remote employees, manage virtually, have different personalities, ages, work ethics and especially when there is a lure of better opportunities elsewhere. Leaders want results. All the strategies and tactics in the world won't make a difference if your people don't execute and "follow you into battle". The key to better leadership is motivating your teams to want to execute, want to work harder, want to work as a team, all while improving morale. Anyone can force employees by threatening them. This session teaches a 180-degree approach. Objectives/Outcomes: 1. Learn the 3 ways this leadership approach differs from traditional leadership, 2. Use a simple process to increase engagement and loyalty, 3. Implement strategies to drive performance. The approach being taught inspires, motivates, engages, and helps to attract better employees.

Keywords: leadership, success, communication, skills

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Authors: Zulfikar Dinar Wahidayat Putra

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Water scarcity become a major challenge in an arid area. One of the arid areas is La Serena city in the Northern Chile which become a case study of this paper. Based on that, this paper tries to identify a sustainable water system by using urban harvest approach as a method to achieve water self-sufficiency for a neighborhood area in the La Serena city. By using the method, it is possible to create sustainable water system in the neighborhood area by reducing up to 38% of water demand and 94% of wastewater production even though water self-sufficient cannot be fully achieved, because of its dependency to the drinking water supply from water treatment plant of La Serena city.

Keywords: arid area, sustainable water system, urban harvest approach, self-sufficiency

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Authors: Fatima El Kandoussi, Hind Benouakrim, Afafe El Amrani El Hassani

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CSR in the relational approach is imposed today as a matter of concerns lighthouses in the academic environment and managerial. This study presents the issues of the CSR dimension in the field of relationship marketing. This exploratory research was conducted with two groups of Moroccan enterprises having the label of the CSR /CGEM. It presents a better understanding of the approaches taken by the companies interviewed in a CSR and contributed to understand the reasons that lead them to adopt the process of CSR and also allows explaining how these enterprises maintain their relationship with the most important customers in a context of CSR.

Keywords: relationship marketing, CSR, stakeholders, business

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Authors: I. Bentchikou, A. Tlemcani, F. Boudjema, D. Boukhetala, N. Ould Cherchali

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In this paper, hybrid approach is proposed to regulate the voltages of the floating capacitor multicell inverter and the current in the load. This structure makes it possible to ensure the distribution of the voltage stresses on the various low-voltage semiconductor components connected in series. And as the problem and to keep a constant voltage across the capacitors. Thus, it is necessary to ensure a distribution balanced voltages at the terminals of floating capacitors thanks to Algorithm develop for this, using the Petri nets. So we consider a three-cell converter represented as a hybrid system with eight modes of operation. The operating modes of the system are governed by the control reference voltage and a reference current. Finally, we present the results of the simulation with MATLAB/SIMULINK to illustrate the performances of this approach.

Keywords: hybrid control, floating condensers, multicellular converter, petri nets

Procedia PDF Downloads 118

Authors: Majid Lotfi Ghahroud, Seyed Jalal Tabatabaei, Ebrahim Karami, AmirArsalan Ghergherechi, Amir Ali Saeidi

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In this study, the relationship between investment growth and stock returns of companies listed in Tehran Stock Exchange and whether their relationship -behavioral or risk factors- are discussed. Generally, there are two perspectives; risk-based approach and behavioral approach. According to the risk-based approach due to increase investment, systemic risk and consequently the stock returns are reduced. But due to the second approach, an excessive optimism or pessimism leads to assuming stock price with high investment growth in the past, higher than its intrinsic value and the price of stocks with lower investment growth, less than its intrinsic value. The investigation period is eight years from 2007 to 2014. The sample consisted of all companies listed on the Tehran Stock Exchange. The method is a portfolio test, and the analysis is based on the t-student test (t-test). The results indicate that there is a negative relationship between investment growth and stock returns of companies and this negative correlation is stronger for firms with higher cash flow. Also, the negative relationship between asset growth and stock returns is due to behavioral factors.

Keywords: behavioral theory, investment growth, risk-based theory, stock returns

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Authors: Arthi Ganapathy, Arithra Banerjee, Saroj Kaler

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Abdominal aorta is the sole purveyor of all organs in the abdomen. Anomalies of its main trunk or its branches are to be meticulously observed as it effects the perfusion of an organ. Varying patterns of the testicular artery is one of them. The origin and course of testicular arteries have to be identified carefully during various surgical procedures like renal transplant, intra abdominal surgeries and even in orthopedic surgery like spine surgery. With the advent of new intra-abdominal therapeutic and diagnostic techniques, the anatomy of testicular arteries has assumed much more significance. Though the variations of the testicular vein are well documented, the variations of the testicular artery are not so frequent in incidence. We report a case of the bilateral aberrant origin of the testicular artery from polar renal arteries. We also discuss its developmental basis. Such anomalies if left unnoticed will lead to serious intraoperative complications during procedures on retroperitoneal organs. Any damage to testicular arteries will compromise the function of the gonads.

Keywords: cadaver, gonadal, renal, surgery

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Authors: Sizwe Dlamini

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There seems to be little that has been done to investigate cartoons from a literary criticism point of view. Cartoons have been given attention mostly in semiotics as compared to other scholarly perspectives. The aim of this article is to attempt to bridge this gap by observing cartoons through the post-colonial approach as a literary theory. Even though the post-colonial approach has been previously adopted to critique the prose genre and other genres in the African indigenous languages of South Africa, there seems to be no study that has used this approach to analyse the cartoon genre. This study is thus believed to be valuable to scientific knowledge in this sense. The study adopts textual analysis as a qualitative research technique since cartoons are the primary sources of data collection. Through the application of the post-colonial theory, the findings of the study demonstrate that there are depicted socio-cultural, socio-economic, and political issues in Mngadi’s editorial cartoons. These include.

Keywords: editorial cartoons, post-colonial theory, literary criticism, turmoil

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Authors: Guldana Zhigerbayeva, Ming Yang

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Transportation of hazardous materials (HAZMAT) is inevitable in the process industries. The statistics show a significant number of accidents has occurred during the transportation of HAZMAT. This makes risk management of HAZMAT transportation an important topic. The tree-based methods including fault-trees, event-trees and cause-consequence analysis, and Bayesian network, have been applied to risk management of HAZMAT transportation. However, there is limited work on the development of a systematic approach. The existing approaches fail to build up the linkages between the regulatory requirements and the safety measures development. The analysis of historical data from the past accidents’ report databases would limit our focus on the specific incidents and their specific causes. Thus, we may overlook some essential elements in risk management, including regulatory compliance, field expert opinions, and suggestions. A systematic approach is needed to translate the regulatory requirements of HAZMAT transportation into specified safety measures (both technical and administrative) to support the risk management process. This study aims to first adapt the House of Quality (HoQ) to House of Safety (HoS) and proposes a new approach- Safety Function Deployment (SFD). The results of SFD will be used in a multi-criteria decision-support system to develop find an optimal route for HazMats transportation. The proposed approach will be demonstrated through a hypothetical transportation case in Kazakhstan.

Keywords: hazardous materials, risk assessment, risk management, quality function deployment

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Authors: Sujeet Kumar Singh, Shiv Prasad Yadav

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This paper develops an approach for solving intuitionistic fuzzy linear fractional programming (IFLFP) problem where the cost of the objective function, the resources, and the technological coefficients are triangular intuitionistic fuzzy numbers. Here, the IFLFP problem is transformed into an equivalent crisp multi-objective linear fractional programming (MOLFP) problem. By using fuzzy mathematical programming approach the transformed MOLFP problem is reduced into a single objective linear programming (LP) problem. The proposed procedure is illustrated through a numerical example.

Keywords: triangular intuitionistic fuzzy number, linear programming problem, multi objective linear programming problem, fuzzy mathematical programming, membership function

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Authors: Yi-Lin Chen, Sheng-Jou Hung, Tsunglin Liu

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Adaptive immune system recognizes a wide range of antigens via expressing a large number of structurally distinct T cell and B cell receptor genes. The distinct receptor genes arise from complex rearrangements called V(D)J recombination, and constitute the immune repertoire. A common method of profiling immune repertoire is via amplifying recombined receptor genes using multiple primers and high-throughput sequencing. This multiplex-PCR approach is efficient; however, the resulting repertoire can be distorted because of primer bias. To eliminate primer bias, 5’ RACE is an alternative amplification approach. However, the application of RACE approach is limited by its low efficiency (i.e., the majority of data are non-regular receptor sequences, e.g., containing intronic segments) and lack of the convenient tool for analysis. We propose a computational tool that can correctly identify non-regular receptor sequences in RACE data via aligning receptor sequences against the whole gene instead of only the exon regions as done in all other tools. Using our tool, the remaining regular data allow for an accurate profiling of immune repertoire. In addition, a RACE approach is improved to yield a higher fraction of regular T-cell receptor sequences. Finally, we quantify the degree of primer bias of a multiplex-PCR approach via comparing it to the RACE approach. The results reveal significant differences in frequency of VJ combination by the two approaches. Together, we provide a new experimental and computation pipeline for an unbiased profiling of immune repertoire. As immune repertoire profiling has many applications, e.g., tracing bacterial and viral infection, detection of T cell lymphoma and minimal residual disease, monitoring cancer immunotherapy, etc., our work should benefit scientists who are interested in the applications.

Keywords: immune repertoire, T-cell receptor, 5' RACE, high-throughput sequencing, sequence alignment

Procedia PDF Downloads 191

Authors: Vareesha Masood, Ammara Gul, Nabeeha Areej, Muhammad Asif Masood, Hamna Imran

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The universal use of PDF files has prompted hackers to use them for malicious intent by hiding malicious codes in their victim’s PDF machines. Machine learning has proven to be the most efficient in identifying benign files and detecting files with PDF malware. This paper has proposed an approach using a decision tree classifier with parameters. A modern, inclusive dataset CIC-Evasive-PDFMal2022, produced by Lockheed Martin’s Cyber Security wing is used. It is one of the most reliable datasets to use in this field. We designed a PDF malware detection system that achieved 99.2%. Comparing the suggested model to other cutting-edge models in the same study field, it has a great performance in detecting PDF malware. Accordingly, we provide the fastest, most reliable, and most efficient PDF Malware detection approach in this paper.

Keywords: PDF, PDF malware, decision tree classifier, random forest classifier

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Authors: Pilly Joseph Kagosi

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The study aims at assessing challenges observed during implementation of participatory irrigation management (PIM) approach for food security in semi-arid areas of Tanzania. Data were collected through questionnaire, PRA tools, key informants discussion, Focus Group Discussion (FGD), participant observation and literature review. Data collected from questionnaire was analyzed using SPSS while PRA data was analyzed with the help of local communities during PRA exercise. Data from other methods were analyzed using content analysis. The study revealed that PIM approach has contribution in improved food security at household level due to involvement of communities in water management activities and decision making which enhanced availability of water for irrigation and increased crop production. However there were challenges observed during implementation of the approach including; minimum participation of beneficiaries in decision making during planning and designing stages, meaning inadequate devolution of power among scheme owners; Inadequate and lack of transparency on income expenditure in Water Utilization Associations’ (WUAs), water conflict among WUAs members, conflict between farmers and livestock keepers and conflict between WUAs leaders and village government regarding training opportunities and status; WUAs rules and regulation are not legally recognized by the National court and few farmers involved in planting trees around water sources. However it was realized that some of the mentioned challenges were rectified by farmers themselves facilitated by government officials. The study recommends that, the identified challenges need to be rectified for farmers to realize impotence of PIM approach as it was realized by other Asian countries.

Keywords: potentials of implementing participatory approach, challenges of participatory approach, irrigation management, Tanzania

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Authors: Shan-Jen Cheng, Te-Jen Chang, Kuang-Hsiung Tan, Shou-Ling Kuo

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Polymer Electrolyte Membrane Fuel Cell (PEMFC) is such a time-vary nonlinear dynamic system. The traditional linear modeling approach is hard to estimate structure correctly of PEMFC system. From this reason, this paper presents a nonlinear modeling of the PEMFC using Neural Network Auto-regressive model with eXogenous inputs (NNARX) approach. The multilayer perception (MLP) network is applied to evaluate the structure of the NNARX model of PEMFC. The validity and accuracy of NNARX model are tested by one step ahead relating output voltage to input current from measured experimental of PEMFC. The results show that the obtained nonlinear NNARX model can efficiently approximate the dynamic mode of the PEMFC and model output and system measured output consistently.

Keywords: PEMFC, neural network, nonlinear modeling, NNARX

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Authors: Abhishek Sharma, Amit Gupta, Manish Singhal

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Background: The management of patients with penetrating neck injuries in the prehospital setting and in the emergency department has evolved with regard to the use of multidetector computed tomographic (MDCT) imaging. Hence, there is a shift in the management of neck injuries from mandatory exploration in certain anatomic areas to more conservative approach using imaging and so-called “no zone approach”. Objective: To study the no zone approach in the management of penetrating neck injury using routine imaging in all stable patients. Methods: 137 patients with penetrating neck injury attending emergency department of level 1 trauma centre at AIIMS between 2008–2014 were retrospectively analysed. All hemodynamically stable patients were evaluated using CT scanning. Results: Stab injury is most common (55.91%) mode of pni in civilian population followed by gunshot(18.33%). The majority of patients could be managed with imaging and close observation. 39 patients (28.46%) required operative intervention. The most common indication for operative intervention was vascular followed by airway injury manifesting as hemodynamic destabilisation.There was no statistical difference between the zonal distribution of injuries in patients managed conservatively and those taken to OR. Conclusions: Study shows that patients with penetrating neck trauma who are haemodynamically stable and exhibit no “hard signs” of vascular injury or airway injury may be evaluated initially by MDCT imaging even when platysma violation is present. “No Zone” policy may be superior to traditional zone wise management.

Keywords: penetrating neck injury, zone approach, CT scanning, multidetector computed tomographic (MDCT)

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Authors: Devieta Romadhon Saendardy

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Introduction: The case of aneurysmal subarachnoid hemorrhage (SAH) associated with intraventricular hemorrhage (IVH) in many way. In general, the anterior communicating artery and posterior circulation aneurysms cause Intraventricular Hemorrhage. The development of intraventricular hemorrhage (IVH) in aneurysmal subarachnoid hemorrhage (aSAH) is linked with higher mortality and poor neurological recovery. Case: This case report presents a 51-year-old female patient who developed IVH following SAH. The patient's Glasgow Coma Scale score was 14, the patient has a severe headache, and there were right extremity hemipharese neurological deficits. A non-contrast head CT scan revealed a massive intraventricular haemorrhage. In an hour, the patient got her headache and pharese worse. Discussion: Intraventricular hemorrhage is a serious complication of subarachnoid hemorrhage, necessitating prompt recognition and management. This case highlights the importance of a time management, medical management and surgical intervention to optimize outcomes in patients with intraventricular hemorrhage caused by subarachnoid hemorrhage. Placement of a shunt system improves clinical outcome in intraventricular hemorrhage.

Keywords: Intraventricular hemorrhage, subarachnoid hemorrhage, shunt, time

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Authors: Spyridon Nikolaidis

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A modeling approach for CMOS gates is presented based on the use of the equivalent inverter. A new model for the inverter has been developed using a simplified transistor current model which incorporates the nanoscale effects for the planar technology. Parametric expressions for the output voltage are provided as well as the values of the output and supply current to be compatible with the CCS technology. The model is parametric according the input signal slew, output load, transistor widths, supply voltage, temperature and process. The transistor widths of the equivalent inverter are determined by HSPICE simulations and parametric expressions are developed for that using a fitting procedure. Results for the NAND gate shows that the proposed approach offers sufficient accuracy with an average error in propagation delay about 5%.

Keywords: CMOS gate modeling, inverter modeling, transistor current mode, timing model

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Authors: Yen Ling Liu, Shu-Fen Wu, Chen-Fuh Lam, I-Ling Tsai, Chia-Yu Chen

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Purpose: Nurse anesthetists are confronting extraordinarily high job stress in their daily practice, deriving from the fast-track anesthesia care, risk of perioperative complications, routine rotating shifts, teaching programs and interactions with the surgical team in the operating room. This study investigated the influence of work stress on the burnout and turnover intention of nurse anesthetists in a regional general hospital in Southern Taiwan. Methods: This was a descriptive correlational study carried out in 66 full-time nurse anesthetists. Data was collected from March 2017 to June 2017 by in-person interview, and a self-administered structured questionnaire was completed by the interviewee. Outcome measurements included the Practice Environment Scale of the Nursing Work Index (PES-NWI), Maslach Burnout Inventory (MBI) and nursing staff turnover intention. Numerical data were analyzed by descriptive statistics, independent t test, or one-way ANOVA. Categorical data were compared using the chi-square test (x²). Datasets were computed with Pearson product-moment correlation and linear regression. Data were analyzed by using SPSS 20.0 software. Results: The average score for job burnout was 68.7916.67 (out of 100). The three major components of burnout, including emotional depletion (mean score of 26.32), depersonalization (mean score of 13.65), and personal(mean score of 24.48). These average scores suggested that these nurse anesthetists were at high risk of burnout and inversely correlated with turnover intention (t = -4.048, P < 0.05). Using linear regression model, emotional exhaustion and depersonalization were the two independent factors that predicted turnover intention in the nurse anesthetists (19.1% in total variance). Conclusion/Implications for Practice: The study identifies that the high risk of job burnout in the nurse anesthetists is not simply derived from physical overload, but most likely resulted from the additional emotional and psychological stress. The occurrence of job burnout may affect the quality of nursing work, and also influence family harmony, in turn, may increase the turnover rate. Multimodal approach is warranted to reduce work stress and job burnout in nurse anesthetists to enhance their willingness to contribute in anesthesia care.

Keywords: anesthesia nurses, burnout, job, turnover intention

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Authors: Bourama Mane, Ibrahima Fall, Mamadou Samba Camara, Alassane Bah

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At the level of the National Statistical Institutes, there is a large volume of data which is generally in a format which conditions the method of publication of the information they contain. Each household or business data collection project includes a dissemination platform for its implementation. Thus, these dissemination methods previously used, do not promote rapid access to information and especially does not offer the option of being able to link data for in-depth processing. In this paper, we present an approach to modeling these data to publish them in a format intended for the Semantic Web. Our objective is to be able to publish all this data in a single platform and offer the option to link with other external data sources. An application of the approach will be made on data from major national surveys such as the one on employment, poverty, child labor and the general census of the population of Senegal.

Keywords: Semantic Web, linked open data, database, statistic

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Authors: Benmoussa Rachid, Deguio Roland, Dubois Sebastien, Rasovska Ivana

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Implementation of LARG (Lean, Agile, Resilient, Green) practices in the supply chain management is a complex task mainly because ecological, economical and operational goals are usually in conflict. To implement these LARG practices successfully, companies’ need relevant decision making tools allowing processes performance control and improvement strategies visibility. To contribute to this issue, this work tries to answer the following research question: How to master performance and anticipate problems in supply chain LARG practices implementation? To answer this question, a risk management approach (RMA) is adopted. Indeed, the proposed RMA aims basically to assess the ability of a supply chain, guided by “Lean, Green and Achievement” performance goals, to face “agility and resilience risk” factors. To proof its relevance, a logistics academic case study based on simulation is used to illustrate all its stages. It shows particularly how to build the “LARG risk map” which is the main output of this approach.

Keywords: agile supply chain, lean supply chain, green supply chain, resilient supply chain, risk approach

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Authors: Radhia Toujani, Jalel Akaichi

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Social Networks generally present a hierarchy of communities. To determine these communities and the relationship between them, detection algorithms should be applied. Most of the existing algorithms, proposed for hierarchical communities identification, are based on either agglomerative clustering or divisive clustering. In this paper, we present a hybrid hierarchical clustering approach for community detection based on both bottom-up and bottom-down clustering. Obviously, our approach provides more relevant community structure than hierarchical method which considers only divisive or agglomerative clustering to identify communities. Moreover, we performed some comparative experiments to enhance the quality of the clustering results and to show the effectiveness of our algorithm.

Keywords: agglomerative hierarchical clustering, community structure, divisive hierarchical clustering, hybrid hierarchical clustering, opinion mining, social network, social network analysis

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Authors: Irina Khutsishvili

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The presented study develops a decision support methodology for multi-criteria group decision-making problem. The proposed methodology is based on the TOPSIS (Technique for Order Performance by Similarity to Ideal Solution) approach in the hesitant fuzzy environment. The main idea of decision-making problem is a selection of one best alternative or several ranking alternatives among a set of feasible alternatives. Typically, the process of decision-making is based on an evaluation of certain criteria. In many MCDM problems (such as medical diagnosis, project management, business and financial management, etc.), the process of decision-making involves experts' assessments. These assessments frequently are expressed in fuzzy numbers, confidence intervals, intuitionistic fuzzy values, hesitant fuzzy elements and so on. However, a more realistic approach is using linguistic expert assessments (linguistic variables). In the proposed methodology both the values and weights of the criteria take the form of linguistic variables, given by all decision makers. Then, these assessments are expressed in triangular fuzzy numbers. Consequently, proposed approach is based on triangular hesitant fuzzy TOPSIS decision-making model. Following the TOPSIS algorithm, first, the fuzzy positive ideal solution (FPIS) and the fuzzy negative-ideal solution (FNIS) are defined. Then the ranking of alternatives is performed in accordance with the proximity of their distances to the both FPIS and FNIS. Based on proposed approach the software package has been developed, which was used to rank investment projects in the real investment decision-making problem. The application and testing of the software were carried out based on the data provided by the ‘Bank of Georgia’.

Keywords: fuzzy TOPSIS approach, investment project, linguistic variable, multi-criteria decision making, triangular hesitant fuzzy set

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Authors: Ramya Rathan, Miral N. F. Salama

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The variations in the arteries have been drawing attention of anatomists for a long time because of their clinical significance. The brachial artery is the principal artery of the arm which is the continuation of the axillary artery from the lower border of the Teres Major. It terminates into the radial and ulnar arteries below the elbow joint at the neck radius. The present study aims at exploring the clinical significance of the high termination of the brachial artery. During the routine cadaveric dissection of the arm, for the undergraduate students of medicine at our university, we observed a high bifurcation of the radial and the ulnar artery at the midshaft of the humerus. The median nerve was seen passing between these two junctions. Further, the course and the relations of this artery were studied. The accurate knowledge regarding these kinds of variation in the blood vessels is mandatory for planning of designing. General physicians, surgeons and radiologists should keep in mind the variations in the branching pattern of the arteries in their daily medical, diagnostic and therapeutic procedures to avoid complications in diagnostic and surgical procedures.

Keywords: brachial artery, high termination, radial artery, ulnar artery

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Authors: Susan Scott, Dina Hanna, Bassel Zebian, Gary Ruiz, Sreena Das

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Although the number of cases of TB in England has fallen over the last 4 years, it remains an important public health burden with 1 in 20 cases dying annually. The vast majority of cases present in non-UK born individuals with social risk factors. We present a case of non-pulmonary TB presenting in a healthy child born in the UK to professional parents. We present a case of a healthy 10 year old boy who developed acute back pain during school PE. Over the next 5 months, he was seen by various health and allied professionals with worsening back pain and kyphosis. He became increasing unsteady and for the 10 days prior to admission to our hospital, he developed fevers. He was admitted to his local hospital for tonsillitis where he suffered two falls on account of his leg weakness. A spinal X-ray revealed a pathological fracture and gibbus formation. He was transferred to our unit for further management. On arrival, the patient had lower motor neurone signs of his left leg. He underwent spinal fixture, laminectomy and decompression. Microbiology samples taken intra-operatively confirmed Mycobacterium Tuberculosis. He had a positive Mantoux and T-spot and treatment were commenced. There was no evidence of immune compromise. The patient was born in the UK, had a BCG scar and his only travel history had been two years prior to presentation when he travelled to the Phillipines for a short holiday. The patient continues to have issues around neuropathic pain, mobility, pill burden and mild liver side effects from treatment. Discussion: There is a paucity of case reports on spinal TB in paediatrics and diagnosis is often difficult due to the non-specific symptomatology. Although prognosis on treatment is good, a delayed diagnosis can have devastating consequences. This case highlights the continued need for higher index of suspicion and diagnosis in a world with changing patterns of migration and increase global travel. Surgical intervention is limited to the most serious cases to minimise further neurological damage and improve prognosis. There remains the need for a multi-disciplinary approach to deal with challenges of treatment and rehabilitation.

Keywords: tuberculosis, non-pulmonary TB, public health burden, diagnostic challenge

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Authors: Franziska Moser, Martin Trautz, Anna-Lena Beger, Manuel Löwer, Jörg Feldhusen, Jürgen Prell, Alexandra Wormit, Björn Usadel, Christoph Kämpfer, Thomas-Benjamin Seiler, Henner Hollert

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The demand for bio-based materials and components in architecture has increased in recent years due to society’s heightened environmental awareness. Nowadays, most components are being developed via a substitution approach, which aims at replacing conventional components with natural alternatives who are then being processed, shaped and manufactured to fit the desired application. This contribution introduces a novel approach to the development of bio-based products that decreases resource consumption and increases recyclability. In this approach, natural organisms like plants or trees are not being used in a processed form, but grow into a near net shape before then being harvested and utilized as building components. By minimizing the conventional production steps, the amount of resources used in manufacturing decreases whereas the recyclability increases. This paper presents the approach of technical product harvesting, explains the theoretical basis as well as the matching process of product requirements and biological properties, and shows first results of the growth manipulation studies.

Keywords: design with nature, eco manufacturing, sustainable construction materials, technical product harvesting

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Authors: Sakine Sincer

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In today’s world, which takes further steps towards globalization each and every day, societies and cultures are re-shaped while the demands of the changing world are described once more. In this atmosphere, where the speed of change sometimes reaches a terrifying point, it is possible to state that effective leaders are needed more than ever in order to meet the above-stated needs and demands. The question of what effective leadership is keeping its importance on the agenda. Most of the answers to this question has mostly focused on the approach of distributed leadership recently. This study aims at analyzing the applicability of distributed leadership, which is accepted to be an example of effective leadership that can meet the needs of global world, which is changing more and more rapidly nowadays, at higher education institutions in Turkey. Within the framework of this study, first of all, the historical development of distributed leadership is addressed, and then a theoretical framework is drawn for this approach by means of underlying what distributed leadership is and is not. After that, different points of view about the approach are laid out within the borders of opinions expressed by Gronn and Spillane, who are accepted to be the most famous advocators of distributed leadership. Then, exemplar practices of distributed leadership are included in the study before drawing attention to the strengths and weaknesses of this approach. Lastly, the applicability of distributed leadership at higher education institutions in Turkey is analyzed. This study is carried out with the method of literature review by resorting to first- and second-hand sources on distributed leadership.

Keywords: globalization, school leadership, distributed leadership, higher education, management

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Authors: Ouassila Labbani-Narsis, Christophe Nicolle

Abstract:

Building formal ontologies remains a complex process for companies. In the literature, this process is based on the technical knowledge and expertise of domain experts, without further details on the used methodologies. Possible problems of disagreements between experts, expression of tacit knowledge related to high level know-how rarely verbalized, qualification of results by using cases, or simply adhesion of the group of experts, remain currently unsolved. This paper proposes a methodological approach based on knowledge elicitation for the conception of formal, consensual, and shared ontologies. The proposed approach is experimentally tested on industrial collaboration projects in the field of manufacturing (associating knowledge sources from multinational companies) and in the field of viticulture (associating explicit knowledge and implicit knowledge acquired through observation).

Keywords: collaborative ontology engineering, knowledge elicitation, knowledge engineering, knowledge management

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Authors: Lina Lukusa, Ulrike Rivett

Abstract:

Poor water management can increase the extreme pressure already faced by water scarcity. Unless water management is addressed holistically, water quality and quantity will continue to degrade. A holistic approach to water management named Water Sensitive Urban Design (WSUD) has thus been created to facilitate the effective management of water. Traditionally, water management has employed a linear design approach, while WSUD requires a systematic, cyclical approach. In simple terms, WSUD assumes that everything is connected. Hence, it is critical for different stakeholders involved in WSUD to engage and reach a consensus on a solution. However, many stakeholders in WSUD have conflicting interests. Using the soft system methodology (SSM), developed by Peter Checkland, as a problem-solving method, decision-makers can understand this problematic situation from different world views. The SSM addresses ill and complex challenging situations involving human activities in a complex structured scenario. This paper demonstrates how SSM can be applied to understand the complexity of stakeholder engagement in WSUD. The paper concludes that SSM is an adequate solution to understand a complex problem better and then propose efficient solutions.

Keywords: co-design, ICT platform, soft systems methodology, water sensitive urban design

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Authors: Jocelyn L. Alimondo, Juna O. Sabelo

Abstract:

This study explored the MTB-MLE implementation practices of teachers in one monolingual elementary school and one multilingual elementary school in Benguet, Philippines. It used phenomenological approach employing participant-observation, focus group discussion and individual interview. Data were gathered using a video camera, an audio recorder, and an FGD guide and were treated through triangulation and coding. From the data collected, varied ways in implementing the MTB-MLE program were noted. These are: Teaching using a hybrid first language, teaching using a foreign LOI, using translation and multilingual instruction, and using L2/L3 to unlock L1. However, these practices come with challenges such as the a conflict between the mandated LOI and what pupils need, lack of proficiency of teachers in the mandated LOI, facing unreceptive parents, stagnation of knowledge resulting from over-familiarity of input, and zero learning resulting from an incomprehensible language input. From the practices and challenges experienced by the teachers, a model of MTB-MLE approach, the 3L-in-one approach, to teaching was created to illustrate the practice which teachers claimed to be the best way to address the challenges besetting them while at the same time satisfying the academic needs of their pupils. From the findings, this paper concludes that despite the challenges besetting the teachers, they still displayed creativity in coming up with relevant teaching practices, the unreceptiveness of some teachers and parents sprung from the fact that they do not understand the real concept of MTB-MLE, greater challenges are being faced by teachers in multilingual school due to the diverse linguistic background of their clients, and the most effective approach in implementing MTB-MLE is the multilingual approach, allowing the use of the pupils’ mother tongue, L2 (Filipino), L3 (English), and other languages familiar to the students.

Keywords: MTB-MLE Philippines, MTB-MLE model, first language, multilingual instruction

Procedia PDF Downloads 421